Antihypertensive medication use among US adults with hypertension

Background - High blood pressure can be controlled through existing antihypertensive drug therapy. This study examined trends in prescribed antihypertensive medication use among US adults with hypertension and compared drug utilization patterns with recommendations of the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Methods and Results - Persons aged >= 18 years from the National Health and Nutrition Examination Surveys were identified as hypertensive on the basis of either a blood pressure >= 140/90 mm Hg or self-reported current treatment for hypertension with a prescription medication. In 1999 - 2002, 62.9% of US hypertensive adults took a prescription antihypertensive medication compared with 57.3% during 1988 - 1994 ( P < 0.01). Men had the greatest increase in antihypertensive medication use (47.5%, 1988 - 1994 versus 57.9%, 1999 - 2002 [ P < 0.001]). In both surveys, antihypertensive medication use increased with age, was lower among men than among women, and was lower among Mexican Americans than among non-Hispanic whites and blacks. Multiple antihypertensive drug use increased from 29.1% to 35.8% ( P < 0.001). Polytherapy with a calcium channel blocker, beta-blocker, or angiotensin-converting enzyme inhibitor significantly increased by 30%, 42%, and 68%, respectively, whereas monotherapy with a diuretic or beta-blocker significantly decreased. For hypertensives with diabetes, congestive heart failure, or a prior heart attack, the utilization patterns closely followed the Sixth Joint National Committee guideline recommendations. Conclusions - Antihypertensive medication use and multiple antihypertensive medication use among US hypertensive adults increased over the past 10 years, but disparities by sociodemographic factors continue to exist.